Parenting stress predicts longitudinal change in parental involvement among mothers living with HIV.

Mothers living with HIV (MLH) face unique challenges that may compound parenting stress and impede effective parenting practices. Among the general population, research has demonstrated bidirectional longitudinal relations between parenting stress and parenting practices; yet, despite the additional stressors faced by MLH, these processes have not been examined longitudinally in this population. Utilizing the process model of parenting, the present study examined the longitudinal relations between parenting stress and parental involvement among a sample of MLH with children aged 6-14 years ( = 174).

Accelerated idioventricular rhythm in newborns: a worrisome but benign entity with or without congenital heart disease.

Broad QRS rhythms (fast and slow) are worrisome findings in newborns. We present five cases with varied clinical presentations found to have broad QRS tachycardias, consistent with idioventricular rhythms. Each patient had an excellent prognosis because the tachycardias resolved, and eventually the patients were in sinus rhythm.

Suspected vasculitis in an adolescent female with cardiomyopathy, myocardial infarction, and heart failure requiring heart transplantation.

A 15-year-old girl presented with dilated cardiomyopathy, positive cardiac markers, and electrocardiogram changes suggestive of acute coronary syndrome. Coronary angiography showed giant dilated coronary arteries. Pathological evidence for cardiomyopathy with acute myocardial infarction was present in the explanted heart.

Effect of palliative and corrective surgery on ventricular volumes in complete atrioventricular canal.

The effect of pulmonary artery banding (PAB) and intracardiac repair on ventricular volumes was studied in 35 patients with uncomplicated complete atrioventricular canal (CAVC). Right ventricular (RV) and left ventricular (LV) end-diastolic volumes (EDV), determined from biplane cineangiograms using Simpson's rule, were expressed as a percent of normal mean (% Nl) for body surface area; normal range (mean +/- 1SD) is equivalent to 75%-125% Nl. In preoperative studies (RV 26, LV 33), EDV averaged 149 +/- 51% and 184 +/- 50% Nl, respectively, P vs Nl less than 0.

Etiology of atrioventricular-conduction abnormalities following cardiac surgery.

Atrioventricular-nodal-conduction abnormalities following cardiac surgery have been attributed to the potassium ion in cardioplegic solutions. To clarify the etiology of these rhythm problems, 15 dogs were subjected to (I) 60 min 4 degrees C potassium cardioplegic arrest; (II) 30 min normothermic ischemic arrest; or (III) cardiac hypothermia without ischemia. In sinus rhythm and during atrial pacing, A-H and H-V intervals, Wenckebach cycle length (WCL), atrial- and AV-nodal refractory periods (ARP and NRP) were measured at 37 degrees C before and 30 min after arrest (groups I and II) and at various myocardial temperatures (group III).

Pathologic measurements in aortic atresia.

Detailed autopsy measurements were performed in 13 infants with hypoplastic left ventricle and aortic atresia. Emphasis was placed on the evaluation of changes in the right ventricle, since its function may be important in determining surgical survival. Other important aspects were the ascending aortic and transverse aortic arch diameter, the presence of left atrial obstruction, and the size of the left atrium.

Efficacy of pulmonary artery banding in infants with complete atrioventricular canal.

Total correction in infants less than 1 year old with complete atrioventricular (AV) canal carries a significant operative mortality. However, past reports suggest that the alternative palliative procedure, pulmonary artery banding (PAB), may be contraindicated in the presence of severe mitral insufficiency and/or a large left ventricular to right atrial shunt. Contrary to these previous reports, we report the results in 21 consecutive patients with congestive heart failure who underwent PAB at a mean age of 3.

Quantitative angiographic and morphologic aspects of aortic valve atresia.

Quantitative angiographic measurements were performed in 15 infants aged 1 to 35 days who had aortic valve atresia with intact ventricular septum and hypoplastic left ventricle. Thirteen infants had similar measurements performed at autopsy. The latter measurements were smaller than those found at angiography (because of shrinkage), but their relationship was predictable.

Prostaglandin E1 infusion in newborns with hypoplastic left ventricle and aortic atresia.

Prostaglandin E1 (PGE1) infusion was used in 7 infants with hypoplastic left ventricle and aortic atresia. Of 5 non-operated patients, 4 died shortly after the onset of PGE1 infusion and 1 survived for 30 hours. Of the infants who had surgery, 1 died during the operation and 1 survived for 38 days.

The conduction system in Pompe's disease.

We report our findings in the microscopic examination of the conduction system in four infants with glycogen storage disease, one of whom had adequate electrophysiologic studies. The electrophysiologic studies in the latter case showed P-A and A-H intervals at the lower limits of normal, but the H-V interval was just above the normal mean. This suggests that the rapid conduction was not localized in the anatomic counterpart of the H-V interval.

Double outlet right ventricle with subvalvular aortic stenosis.

A case of double outlet right ventricle had progressive muscular subvalvular aortic stenosis unrelated to the ventricular septal defect. Ventricular systolic pressures were identical and higher than aortic, and the gradient was within the right ventricle. Selective angiocardiography showed a hypertrophied subaortic conus obstructing the right ventricular outlet.

Interrupted aortic arch operation in the first week of life: hemodynamic and angiographic evaluation one year later.

Operation for interrupted aortic arch (IAA) was successful in 2 infants during the first week of life. Both had postoperative hemodynamic and angiographic evaluation at one year of age. The first infant had a type A IAA, and prostaglandins were infused to prevent ductal closure prior to the insertion of a graft between the two ends of the interrupted aorta.

Correlation of angiographic and autopsy left ventricular dimensions in children.

To evaluate controlled pressure coronary artery perfusion fixation of hearts as a means of obtaining meaningful cardiac measurements at autopsy, left ventricular (LV) autopsy measurements were correlated with in vivo end-diastolic (D) and end-systolic (S) angiographic (angio) values from biplane cineangiograms in the same patients. Mitral (MV) and aortic valve (AV) circumferences, LV equatorial circumference (Circ), spatial inflow and outflow lengths, wall thickness (W) and LV volume (Vol) were measured in 34 children with congenital heart disease. All dimensions showed significant correlation of angiographic and autopsy data from which linear regression equations were derived.

Right aortic arch, right patent ductus arteriosus, and mirror-image branching of the brachiocephalic vessels.

Two patients with a right aortic arch, right patent ductus arteriosus, and mirror-image branching of the brachiocephalic vessels are described. The clinical, angiographic, and surgical findings in these two cases are detailed, and a description of the embryologic basis for these anomalies is given.

Right and left ventricular volume characteristics in common atrioventricular canal.

Right (RV) and left (LV) ventricular volume characteristics were determined from biplane cineangiography in 29 patients with atrioventricular canal (AVC). The patients were classified into two groups: group I (N = 19), uncomplicated AVC; group II (N = 10), AVC associated with RV obstruction. In group I, LV end-diastolic volume (EDV) [177 +/- 9 (SEM)% of normal] and RVEDV (125 +/- 9%) both were greater than normal (P is less than 0.

A new prenatal cardiac diagnostic device for congenital heart disease.

A unique case of congenital heart disease and complete heart block diagnosed by fetal electrocardiogram (ECG) and phonocardiogram recorded initially at 32 weeks gestation is presented. The slow, regular fetal heart rate of approximately 50 beats/min with bizarre QRS and a diamond-shaped murmur beginning with the fetal QRS complex made a diagnosis of complete heart block (CHB) and associated congenital heart disease highly probable. Direct fetal electrocardiograms (FECG) recorded during labor and vaginal delivery at term confirmed the diagnosis of completel atrioventricular block.

Bradycardia preceding apneic attacks in low-birthweight infants. The relationship and management.

Two premature infants had frequent episodes of prolonged apnea. The apneic spells were not due to the more commonly known causes of apnea in infancy, but were consistently preceded by severe bradycardia. Atropine or ephedrine produced favorable therapeutic results.

The influence of age on cardiac refractory periods in man.

As age is a determinant of cardiac refractory periods, this communication describes changes of refractory periods in an age continuum of infants, children and adults, 7 months through 77 years. Seventy patients with evidence of normal A-V conduction on scalar electrocardiogram were included. The patients were divided into six age groups: less than 2 years, 3-5 years, 6-10 years, 11-15 years, 16-30 years, and greater than 30 years.

Comparison of ejection phase indices of left ventricular performance in infants and children.

Ejection phase indices of left ventricular myocardial performance, mean velocity of circumferential fiber shortening (mVcf), mean systolic ejection rate (mSER), and ejection fraction (EF) were determined in 248 pediatric patients, utilizing left ventricular projections of cineangiograms. Heart rate significantly affected mVcf and mSER values in the normal group (r=0.74, 0.

Intermittent functional closure of patent ductus arteriosus in a ten-month-old infant; hemodynamic documentation.

We describe a ten-month-old patient in whom intermittent patency and closure of the dectus arteriosus was observed clinically, and in whom this observation was uniquely demonstrated at the time of cardiac catheterization. The hemodynamics of this patient and the physiology of ductal closure are discussed.